There are approximately 19 million children under the age of 5 in the United States, accounting for 6% of the U.S. population. When this youngest cohort became eligible to receive COVID-19 vaccinations, vaccine uptake and demand remained low. Higher immunization levels are critical to protecting this age group from hospitalization and death, while vaccine access for young, low-income children is hindered by certain barriers like cost, insurance status, and racial/ethnic health disparities. Recognizing these truths, and the need to deploy effective facilitators to Medicaid program vaccine administration, the Association of Immunization Managers (AIM), AcademyHealth, and the National Academy for State Health Policy (NASHP) came together to create the Vaccine Access Cooperative (VAC).
Building on AcademyHealth and NASHP’s project, Building on AcademyHealth and NASHP’s project, Immunization Barriers in the United States: Targeting Medicaid Partnerships through Community of Practice, and drawing on AIM’s reputation as a trusted source of information and knowledge broker for immunization program and policy staff, the VAC regional meetings were designed to better understand how to address COVID-19 vaccination disparities for children, ages 6 months to five years. Specifically, the meetings focused on identifying best or promising practices and increasing awareness, access, and confidence in COVID-19 vaccines among this population through diverse stakeholder engagement. During each of the regional meetings, state-level decision makers (including state health officials and legislators, and leadership across public health agencies, immunization programs, Medicaid programs, and diversity, equity, and inclusion (DEI) initiatives) and cross-sector partners that play important roles in immunization (including American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), immunization coalitions, and pharmacy stakeholders) convened in the following regions and locations:
- Pacific Islands - Honolulu, Hawaii
- Southeast - Asheville, North Carolina
- Great Lakes - Itasca, Illinois at the AAP Headquarters
- Frontier/Southwest - Denver, Colorado
- Heartland - Tulsa, Oklahoma
- Beaches - New Orleans, Louisiana
- West - Portland, Oregon
- Northeast/MidAtlantic - Portland, Maine
At the conclusion of the regional meetings, AcademyHealth and NASHP facilitated an in-person roundtable with the Centers for Disease Control and Prevention (CDC) and other key state and federal leaders to distill lessons learned from the regional meetings to support thought leadership for future federal funding opportunities. The roundtable successfully spurred conversation around emergent themes from the regional meetings, including parental hesitancy, lack of vaccine access, and lack awareness around the importance of vaccinating children of this age. Furthermore, the roundtable highlighted important opportunities for additional federal resources, guidance, and support, such as providing timely and clear communication on commercialization impacts on vaccine payment and ordering processes and developing additional CMS incentives and performance measures for COVID-19 vaccines, including the exploration of developing a COVID-19 vaccine HEDIS measure. Additionally, the roundtable highlighted that vaccination efforts at the local level would benefit from continued messaging from federal partners that COVID-19 is still with us, especially when targeting parents of infants who are newly eligible and may have never had the conversation with a healthcare provider.